Choosing Wisely:

Don’t perform imaging of the carotid arteries for simple syncope without other neurologic symptoms.

Occlusive carotid artery disease does not cause fainting but rather causes focal neurologic deficits such as unilateral weakness. Thus, carotid imaging will not identify the cause of the fainting and increases cost. Fainting is a frequent complaint, affecting 40% of people during their lifetime.

Sponsoring Organizations:

American Academy of Neurology

Sources:

National Institute for Health and Clinical Excellence guidelines

American Heart Association guidelines

Disciplines:

Neurologic

References:

• AHA/ACCF scientific statement on the evaluation of syncope. Circulation. 2006;113:316-27.
• The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology. Guidelines for the diagnosis and management of syncope. http://www.escardio. org/guidelines-surveys/esc-guidelines/guidelinesdocuments/ guidelines-syncope-ft.pdf.
• National Institute for Health and Clinical Excellence. Transient loss of consciousness (“blackouts”) management in adults and young people. London, U.K.: Royal College of Physicians; 2010.